Shanmugam Subbiah, Govindasamy Gopu, Hussain Syed Afroze, Rao Prasanna Srinivasa H
Department of Surgical Oncology, Government Royapettah Hospital, Kilpauk Medical College, Chennai, Tamil Nadu, India.
Indian J Cancer. 2017 Jul-Sep;54(3):543-546. doi: 10.4103/ijc.IJC_289_17.
The major morbidities of modified radical mastectomy both short- and long-term are sequelae of axillary dissection. Flap complications, prolonged seroma, need for axillary drainage, wound infection, lymphedema, shoulder stiffness, and paresthesia are major causes for morbidity after axillary dissection. Different techniques have been implemented to tackle these problems. Few of these include reducing the axillary dead space, using various forms of energy devices.
We have prospectively compared two energy sources, namely, ultrasonic dissector (UD) against the electrocautery dissection in axillary dissection for breast cancer with respect to outcomes.
One hundred female patients with breast cancer undergoing modified radical mastectomy were randomized to either of the two arms - axillary dissection using UD and axillary dissection using electrocautery. The parameters taken into consideration were operating time, operative blood loss, amount and duration of axillary drainage, flap complications, nodal yield, and postoperative pain scoring.
There were no significant differences overall between the two groups with respect to oncological safety and functional outcomes.
改良根治性乳房切除术的主要短期和长期并发症是腋窝淋巴结清扫的后遗症。皮瓣并发症、持续性血清肿、腋窝引流需求、伤口感染、淋巴水肿、肩部僵硬和感觉异常是腋窝淋巴结清扫术后发病的主要原因。已经采用了不同的技术来解决这些问题。其中一些包括减少腋窝死腔、使用各种形式的能量装置。
我们前瞻性地比较了两种能量源，即超声刀（UD）与电灼法在乳腺癌腋窝淋巴结清扫中的效果。
100例接受改良根治性乳房切除术的女性乳腺癌患者被随机分为两组——一组使用超声刀进行腋窝淋巴结清扫，另一组使用电灼法进行腋窝淋巴结清扫。考虑的参数包括手术时间、术中失血量、腋窝引流量及持续时间、皮瓣并发症、淋巴结获取量和术后疼痛评分。
两组在肿瘤学安全性和功能结局方面总体无显著差异。
